Co-occurring disorders among mentally ill jail detainees. Implications for public policy

Studies have demonstrated that police often arrest the mentally ill when treatment alternatives would be preferable but are unavailable. Thus, jails may contain disproportionate numbers of severely mentally ill persons who have co-occurring disorders. Data on the co-occurrence of severe mental disorder, substance abuse, and antisocial personality disorders were gathered from 728 randomly selected male urban jail detainees. Using difference of proportions tests and loglinear analysis, the authors demonstrated that most subjects with a severe mental disorder (schizophrenia or a major affective disorder) also meet criteria for a substance abuse or antisocial personality disorder. These findings suggest several changes in public policy regarding health care delivery in correctional settings and for the general population.